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Missouri Cancer Registry (MCR)
FAQ about Cancer Reporting for Dermatologists
1.
Will MCR be contacting the patients?
MCR staff do not make direct contact with patients. We rely on reporting facilities to submit
information beginning with the patient’s diagnosis through the first course of treatment as
mandated in 192.650-192.657 RSMo. If MCR needs further information, we follow-back either to
the reporting physician or any other physician/facility listed on the patient’s reporting form.
However, epidemiologists and others engaged in research may wish to obtain case-specific data
that is confidential by law. This data can be released to approved researchers after a thorough
review of requests, including approval at a minimum by the Missouri Department of Health and
Senior Services (DHSS) Institutional Review Board. Any approved researcher given access to
such data is required both by law and by contract with the DHSS to keep that information strictly
confidential.
2.
Will the patient’s right to confidentiality be breached if this information is reported to the
Missouri Cancer Registry?
All cancer cases submitted to MCR are covered by the regulations that accompany the legislation
protecting the identity of the patient, hospital, physician, health care provider, pathology laboratory,
ambulatory surgical center, free-standing cancer clinic or treatment center. (See also Chapters
192.067 and 192.655 of the Missouri Revised Statutes.) HIPAA allows for the reporting of
identifiable cancer data as required by law to public health entities such as the Missouri Cancer
Registry. Neither written informed consent from each patient nor a Business Associate Agreement
is required to report data to a public health entity.
Cancer case reporting to the MCR is similar to reporting communicable or infectious
diseases such as hepatitis C or tuberculosis to the state via the local public health agency
(LPHA). Reporting cancer cases to MCR is the same as reporting communicable diseases
to the LPHA. This is also stated in the Federal Register (Vol.65, no.250): 164.512: Uses and
disclosures for which consent, an authorization, or opportunity to agree or object is not required. (a)
Standard: Uses and disclosures required by law. (b) Standard: uses and disclosures for public
health activities.
3.
Will physicians and other health care professionals be liable for breach of confidentiality?
Physicians and other health care professionals cannot be liable if state law requires reporting of
cancer cases. (See Missouri Revised Statutes, Chapter 92 Department of Health and Senior
Services, Section 192.657.)
4.
What are SNOMED codes?
Some pathology lab software programs typically use SNOMED codes, also known as morphology
codes. This number may appear on pathology reports.
5.
Should we report patients seen only for consults or second opinions?
It is not necessary to submit forms for patients only seen in consultation or for a second opinion.
However, it would assist MCR with casefinding if you would complete at least the patient
information and the treating physician information on the form. MCR could then follow-back to that
physician for complete treatment information.
6.
What should we do when the diagnosis is not melanoma, but another cancer?
Other cancers that can be diagnosed by skin biopsies include: cutaneous T cell lymphoma
(mycosis fungoides), kaposi sarcoma, merkel cell (cutaneous neuroendrocine) cancer,
fibroxanthoma, extramammary Paget disease, dermatofibrosarcoma protuberans, cutaneous
metastases, etc. If you have questions about reportability, please call MCR at 866-240-8809.
Please do not use the melanoma cancer-reporting form for these diagnoses. There is another form
that you may use located in the physician-reporting section of the website.
7.
Should we send follow-up information on a patient?
It is not necessary to send additional information on a patient, unless the patient has returned for
previously unreported treatment or for diagnosis/treatment of a new melanoma.
8.
What is the SEER staging system and why do you use it?
Summary staging is the most basic way of categorizing how far a cancer has spread from its point
of origin. Summary staging has also been called General Staging, California Staging, and SEER
Staging. The 2000 version of Summary Stage applies to every anatomic site, including the
lymphomas and leukemias. Summary staging uses all information available in the medical record;
in other words, it is a combination of the most precise clinical and pathological documentation of
the extent of disease. This is the staging system required by the Centers for Disease Control and
Prevention’s (CDC’s) National Program of Cancer Registries (NPCR) as well as by the North
American Association of Central Cancer Registries (NAACCR). Hospital registries approved by the
Commission on Cancer use both the TNM Staging and the SEER Summary Staging.
The melanoma sections of the SEER Summary Staging Guide may be viewed and/or printed from
the MCR website (http://mcr.umh.edu). Those sections are:
MELANOMA OF SKIN, VULVA, PENIS, AND SCROTUM
MELANOMA OF CONJUNCTIVA
MELANOMA OF THE CORNEA, RETINA, CHOROID, CILIARY BODY (Iris, Lens, Sclera,
Uveal tract), EYEVALL, AND OVERLAPPING AND OTHER EYE
For other questions or information please contact Nancy Cole, MCR non-hospital
reporting coordinator toll free at 866-240-8809 or [email protected].
5/3/04, 6/28/04, 10/20/04